Assessing Fitness for Military Enlistment Physical, Medical, and Mental Health Standards (2006) / Chapter Skim
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5 Medical Factors
5 Medical Factors
Pages 109-134
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From page 109... ...
: excessive body mass index (BMI) and body fat (23.3 percent)
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From page 110... ...
In the youth population, the prevalence of overweight in children ages 6 to 11 and adolescents ages 12 to 19 tripled between 1963 and 1999 (U.S. Department of Health and Human Services, 2001)
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From page 111... ...
Current Military Standards Standards for BMI and body fat are determined by each Service. In order to develop a picture of the BMI distribution for first-term recruits, the committee plotted the BMI means and standard deviations found in military personnel basic training studies against the BMI distribution in the youth population, ages 16 to 24.
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From page 112... ...
c 39.3 (2.3) c NOTE: BMI = body mass index, calculated as weight in kilograms divided by square of height in meters.
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From page 113... ...
If the recruit is above the standard, then a body fat measurement is applied. The current DoD BMI screening standard ranges between 25 and 27.5; a BMI of 25 is the most stringent screen, and a BMI of 27.5 is the least stringent screen recommended for use by the Services.
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From page 114... ...
. prevalence White Black Mexican White Black Mexican 1976-1980 1976-1980 obesity Medicine in of 30 25 20 15 10 5 0 30 25 20 15 10 5 0 Percentile BMI 95th Age-Specific and Percentile BMI 95th Age-Specific and Gender- the Above or at Population of Percentage Gender- the Above or at Population of Percentage Trend Institute 5-1 FIGURE SOURCE:
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From page 115... ...
115 ) 2 m (kg/ BMI 100 90 32.6 population.
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From page 116... ...
116 ) 2 m (kg/ BMI 100 90 34.3 population.
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From page 117... ...
As noted above, if a recruit exceeds the BMI screening standard, body fat measures may be taken. There are DoD-recommended body fat measures for men and women that are calculated by formulas that use height and body circumference (DoD Instruction 1308.3, "DoD Physical Fitness and Body Fat Programs Procedures")
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From page 118... ...
+ 36.76 26% 26% 26% Navy Same as DoD 22% 22% 22% Marine Corps Same as DoD 18% 18% 18% Army % body fat = 76.46 × log (abdomen circumference neck circumference) 68.68 × log(height)
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From page 119... ...
Since a measure of endurance fitness is reflective of both physiological fitness and weight status, BMI adds little to a model for predicting injury that includes fitness. According to studies conducted at Fort Jackson and Fort Leonard Wood in the 1980s and 1990s (Jones et al., 1993b; Jones, 1992)
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From page 120... ...
From these data, we projected changes in injury and attrition risk of the recruit population, based on the assumption that the distribution of BMI could shift toward leaner or fatter recruits, either as a result of changes in the U.S. youth population or through future modifications to the current height and weight screening criteria.
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From page 121... ...
It should be noted that this conclusion is based on data from those who qualified under the current standard. There are currently no data on the injury and attrition experience of those who are disqualified under current height and weight body fat standards; however, the currently ongoing Assessment of Recruit Motivation and Strength (ARMS)
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From page 122... ...
suggest that lifting and carrying are the most common military tasks: Typical military lifting tasks include loading artillery shells, lifting sup plies onto and removing them from trucks, moving construction equip ment, and assembling or disassembling heavy equipment. Most lifts involve raising an object from the ground to between waist and shoulder
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From page 123... ...
Friedl (2004) measured changes in body weight during basic training and the first six months following basic training for 1,048 male and 816 female recruits according to initial adiposity.
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From page 124... ...
12 8 (lbs) 4 0 -4 Change -8 -12 End of basic training Weight -16 6 months after basic training -20 <20% 20-22% 22-24% 24-26% 26-28% 28-30% 30-32% >32% % Body Fat at Entry to Active Duty*
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From page 125... ...
The weight loss achieved during basic training may be attributed to diet control and vigorous exercise. As noted above, interventions capable of producing systematic weight loss across broad populations over the long term have not been demonstrated to date.
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From page 126... ...
, and relapse-prevention/limitation skills. However, an additional factor identified among successful weight managers, and one not generally included in discussing weight-management techniques, is individual readiness that is strong personal motivation to succeed in weight management.
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From page 127... ...
. In the group ages 15 to 34, 4 percent report current asthma symptoms with slightly higher rates during the winter months (7 percent)
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From page 128... ...
; a slightly higher percentage of white enlistees received waivers (40 percent) compared with black enlistees (34 percent)
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From page 129... ...
White* FIGURE 5-9 Asthma emergency department visits, 2002.
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From page 130... ...
130 ASSESSING FITNESS FOR MILITARY ENLISTMENT Women*
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From page 131... ...
Recruits can request an asthma waiver and, if granted, can move forward to basic training. Some personnel develop asthma during military service and unless disqualified can continue their duties.
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The greatest frequency of health care use and recruitment loss occurred in basic training. Following training there were no attrition differences between those recruits with or without asthma, although health care costs were higher (relative risk: RR 1.7 for those with asthma)
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From page 133... ...
An appreciable number of potential military recruits can therefore be expected to have asthma. Available data indicate that military personnel with asthma waivers, in fact, have lower attrition rates than those without the condition, although studies show that their health care costs are higher.
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From page 134... ...
It may be that the goal-oriented climate of military recruitment discourages disclosure by some individuals who have asthma. Data suggest that those who have the condition but do not initially disclose it may drop out more frequently from basic training, while those who disclose a history of the illness at the time of enlistment and receive a waiver have lower attrition rates.
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